• Medicare Grievances and Appeals Corporate…

    Humana (Columbus, OH)
    …of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The Corporate Medical ... Director works on problems of diverse scope and complexity...appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents… more
    Humana (01/07/25)
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  • Senior Director Medicare Ops

    Banner Health (AZ)
    …a direct interface with the Arizona Medicaid Agency (AHCCCS), Center of Medicare and Medicaid Services (CMS), Association for Community Affiliated Plans (ACAP), and ... operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved 4. Sets strategic… more
    Banner Health (12/15/24)
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  • Appeal Analyst Pharmacy Medicare

    Corewell Health (Grand Rapids, MI)
    …administer all steps of the Pharmacy appeal and review processes for all Medicare products in a pleasant and expedient manner to ensure quality customer service ... and compliance with all legislative, regulatory and accreditation requirements. Assist...the member appeal and ALJ hearing processes for all Medicare products to thoroughly investigate appeal requests, leveraging critical… more
    Corewell Health (02/13/25)
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  • Medicare Appeals Analyst

    Corewell Health (Grand Rapids, MI)
    …of the member appeal and fair hearing review processes for all non- Medicare products to thoroughly investigate appeal requests, leveraging critical thinking skills, ... systems, and collaboration to resolve issues whenever possible. Ensure compliance with all mandated, legislative, regulatory and accreditation requirements. Assist… more
    Corewell Health (02/12/25)
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  • Associate Medical Director

    CenterWell (Tampa, FL)
    …a part of our caring community and help us put health first** The Associate Medical Director serves as a health-care professional and capable of handling ... a variety of health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities interrelate across… more
    CenterWell (02/13/25)
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  • Associate Medical Director

    CenterWell (Mesa, AZ)
    …a part of our caring community and help us put health first** The Associate Medical Director serves as a health-care professional and capable of handling ... a variety of health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities interrelate across… more
    CenterWell (12/24/24)
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  • Associate Medical Director

    Lancaster General Health (Lancaster, PA)
    …LGHP Hospitalists at LRH, serving as representative of the LGHP Hospitalists practice. The Associate director will report to LGHP Medical Director and have ... clinical staff of LRH. The primary function of the Associate director is to oversee all aspects...the staff of LRH in an effort to ensure compliance with LRH's Medical staff bylaws, Medical staff rules… more
    Lancaster General Health (01/12/25)
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  • Associate Medical Director

    CenterWell (Henderson, NV)
    …the lives of our patients, and the healthcare industry as a whole. The Associate Medical Director serves as a health-care professional and capable of handling ... a variety of health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities interrelate across multiple… more
    CenterWell (01/18/25)
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  • Associate Director of Quality…

    UTMB Health (Galveston, TX)
    Associate Director of Quality Management & Accreditation - Quality Management **Galveston, Texas, United States** Executive UTMB Health Requisition # 2500388 ... of the care processes surrounding patients and families. **Job Summary:** The Associate Director of Quality Management and Accreditation is responsible for… more
    UTMB Health (01/31/25)
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  • Associate Director E, Research…

    University of Pennsylvania (Philadelphia, PA)
    …and wellness programs and resources, and much more. Posted Job Title Associate Director E, Research Administration (Department of Cardiovascular Medicine) Job ... Profile Title Associate Director E, Research, Administration Job Description...(industry, etc.). Understanding and keeping current with FDA and Medicare regulations applicable to clinical trials. Understanding interaction of… more
    University of Pennsylvania (02/13/25)
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  • Associate Director , Contracting…

    Ascendis Pharma (Princeton, NJ)
    …to grow and develop their skills. Ascendis Pharma is looking to hire an Associate Director , Contract Operations to join our team. Responsibilities will include ... demonstrating strong leadership, project management, and communication skills. As the Associate Director , Contracting Operations, you will be responsible for… more
    Ascendis Pharma (02/06/25)
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  • Associate Director , Corporate…

    CSL Behring (King Of Prussia, PA)
    The Associate Director , Corporate Accounts (ADCA) is responsible for optimizing access, reimbursement, and profitability for CSL Behring's portfolio of brands in ... role in CSL Behring's commercial organization and reports to the Senior Director of Corporate Accounts. The ADCA is responsible for executing CSL Behring's… more
    CSL Behring (01/09/25)
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  • Collections Specialist I - Managed Medicare

    Community Health Systems (Franklin, TN)
    …balances; identification of claim problems and resolution; standards within compliance of government and managed care contract terms. **Essential Functions** ... standards. **Qualifications** + HS Diploma or GED required + Associate Degree preferred + 0-1 years Strong interpersonal and...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
    Community Health Systems (02/06/25)
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  • Executive Director , Compliance

    NASCO (Columbus, OH)
    **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the ... company's Compliance and Privacy Official. Responsible for overseeing the company's... Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship… more
    NASCO (02/11/25)
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  • Academic Professional Track (Non-Tenure): Open…

    Texas A&M University - Faculty (Dallas, TX)
    Director of Clinical Compliance include: Under the direct supervision of the Associate Dean of Clinical Affairs, the Director of Clinical Compliance ... Academic Professional Track (Non-Tenure): Open Rank Clinical & Director of Clinical Compliance College of...eClinicalWorks, etc.) . Knowledge of managing patient care, HIPPA compliance , and centers for Medicare and Medicaid… more
    Texas A&M University - Faculty (02/12/25)
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  • Associate Director - Field…

    Bayer (Columbus, OH)
    …brilliant and diverse minds to make a real difference, there's only one choice.** ** Associate Director - Field Reimbursement - Oncology - Ohio Valley** ** ... Associate Director - Field Reimbursement - Oncology...to address individual customer concerns; + Broad knowledge of Medicare , managed care, third party payers and Medicaid; +… more
    Bayer (02/11/25)
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  • Associate Director , Security…

    CenterWell (Columbus, OH)
    …a part of our caring community and help us put health first** The Associate Director , Security Architecture will play a key role in implementing security ... frameworks to ensure the enterprise can achieve the enterprise security strategy. The Associate Director , Security Architecture will play a key role in… more
    CenterWell (02/14/25)
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  • Associate Director Business…

    Humana (Louisville, KY)
    …of our caring community and help us put health first** We are seeking an Associate Director of Business Intelligence to lead and enhance our HEDIS reporting ... program, ensuring accuracy, compliance , and operational efficiency. This role is essential for...outcomes through advanced analytics and business intelligence solutions. The ** Associate Director of Business Intelligence** will be… more
    Humana (02/12/25)
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  • Associate Director Pricing…

    Gilead Sciences, Inc. (Foster City, CA)
    Director , Contracting and Pricing Strategy, Virology, Managed Markets. As ** Associate ** ** Director of US** **Pricing** **&** **Contracting** **Strategy** **, ... Join Gilead and help create possible, together. **Job Description** As the ** Associate D** **irector of US** **Pricing** **&** **Contracting** **Strategy** , within… more
    Gilead Sciences, Inc. (01/23/25)
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  • Associate Director Ambulatory…

    Penn Medicine (Philadelphia, PA)
    …our future each day. Are you living your life's work? **Summary:** + The Associate Director ("AD") will assist in the planning, development, coordination and ... ensure that established policies, goals, and objectives are achieved and in compliance with policies and procedures, standard practices of the profession, and… more
    Penn Medicine (01/01/25)
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